Method and apparatus for applying an anesthetic and batericide

ABSTRACT

A method and an apparatus for applying an anesthetic includes a receptacle having an upper end, a substantially hollow interior, a lower end having a tube or nozzle extending therefrom and an attachment for attaching to the barrel of a syringe or vice versa. The receptacle receives a container or canister containing an endothermic gas or vapor (propellant) that rapidly absorbs heat when released to the atmosphere. A depressible actuating member or trigger propels the gas or vapor through an outlet nozzle that is oriented to project a stream of gas or vapor along a delivery axis that intersects a delivery axis of the needle; therefore, the gas or vapor can be successively delivered to an injection site with minimal repositioning of the housing.

PRIORITY CLAIM

In accordance with 37 C.F.R. 1.76, a claim of priority is included in anApplication Data Sheet filed concurrently herewith. Accordingly, thepresent invention claims priority as a continuation-in-part of U.S.patent application Ser. No. 13,927,454, entitled “METHOD AND APPARATUSFOR APPLYING AN ANESTHETIC AND BACTERICIDE”, filed Jun. 26, 2013, whichis a continuation-in-part of U.S. patent application Ser. No.12/557,753, entitled “METHOD AND APPARATUS FOR APPLYING AN ANESTHETIC”,filed Sep. 11, 2009, now U.S. Pat. No. 8,500,678, issued Aug. 6, 2013,which is a continuation-in-part of U.S. application Ser. No. 11/636,859,entitled “DENTAL SYRINGE”, filed on Dec. 11, 2006, now abandoned, whichclaims the priority to U.S. Provisional Patent Application No.60/733,757, entitled “CRYO-SYRINGE”, filed on Mar. 7, 2006. The contentsof which the above referenced applications are incorporated herein byreference.

FIELD OF THE INVENTION

An apparatus for applying an anesthetic to a patient. In particular, theapparatus comprises a receptacle which is removably attached to asyringe barrel and which accommodates a container comprising ananesthetizing composition.

BACKGROUND

Syringes are employed millions of times daily all over the world toinject medicines into people as well as animals. Many times, injectionsare made in areas of the body that are somewhat less sensitive to pain.Other locations of the body where injections are contemplated aresignificantly more sensitive to pain and the patient feels a pinchingsensation that may be quite painful as the syringe needle is insertedbeneath the skin. Such areas include, for example, gums, areas of theface such as the forehead, as well as the lips. To minimize the painthat results when the injection needle penetrates, for example, apatient's gums, the dental practitioner will often apply a topical agentto the injection site using a cotton swab. Because the deadening agentis only applied topically, it is not effective as it does not cross theskin/mucosal membranes and misleads the patient into a false expectationof a painless injection. As a result, injecting an anesthetic oftencauses significant pain at the injection site.

SUMMARY

There is currently a need for a means of minimizing the pain associatedwith an anesthetic injection. The present invention addresses this needby providing a syringe having a liquid anesthetic, or a liquidanesthetic cartridge and a compressed gas or vapor canister therein, ora receptacle for receiving a gas or vapor canister, wherein thereceptacle comprises a clip for attaching a syringe e.g. piggyback. Onechamber within the syringe or syringe cartridge includes a conventionalanesthetic while the canister includes a compressed, endothermic gas orvapor that rapidly absorbs heat when released to the atmosphere; theendothermic gas or vapor is first applied to the injection site prior tothe anesthetic injection to minimize the pain associated withconventional anesthesia techniques. Furthermore, the gas or vapor alsoblanches the mucosa (along with popping bubbles due to the boiling ofthe liquid phase) allowing a practitioner to readily identify thepretreated injection site so that the needle is not inserted into anunanesthetized area.

Embodiments of the invention are also directed to an apparatuscomprising a syringe, a receptacle which is removably attached to thesyringe barrel and which accommodates a canister comprising a gaseous(vaporous) anesthetizing composition. The receptacle further comprisesan elongated nozzle or a short nozzle for attaching a tube. Theapparatus comprises an actuating member which acts to dispense thecontents of a container or canister containing the anestheticcomposition. The actuating member comprises a lever and a spring biasedmeans for the controlled release of the gaseous (vaporous) anesthetizingcomposition.

Other aspects are described infra.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a plan view of the dental syringe with the cartridge andcanister removed therefrom.

FIG. 2 is a plan view of the dental syringe with the cartridge andcanister installed in their corresponding chambers.

FIG. 3 is a perspective view illustrating an alternative embodiment ofthe present invention.

FIG. 4A is a plan view of one embodiment of a module of the presentinvention.

FIG. 4B is a perspective view of the embodiment illustrated in FIG. 4Aattached to a syringe.

FIG. 4C is a perspective view of the module of FIG. 4A.

FIG. 4D is an exploded of the module of FIG. 4A.

FIG. 5A is a perspective assembly view illustrating an alternativeembodiment of the present invention having a remote tank for holding anendothermic gas or vapor.

FIG. 5B is a perspective assembly view illustrating an alternativeembodiment of the present invention having a remote tank for holding anendothermic gas or vapor.

FIG. 5C is a perspective view of an alternative embodiment of thepresent invention.

FIG. 5D is a partially exploded view of the embodiment illustrated inFIG. 5C.

FIG. 5E is a perspective view of an alternative embodiment of thepresent invention.

FIG. 5F is a partially exploded view of the embodiment illustrated inFIG. 5E.

FIG. 5G is an exploded view of the embodiment illustrated in FIG. 5G.

FIG. 5H is a section view taken along lines 5H-5H of FIG. 5D.

FIG. 5I is a partially exploded view of the embodiment illustrated inFIG. 5H.

FIG. 5J is a perspective view of an alternative embodiment of thepresent invention.

FIG. 5K is a partially exploded view of the embodiment illustrated inFIG. 5J.

FIG. 6 is a plan view of a syringe with the canister installed in themodule or adjunctive chamber.

FIG. 7 is a perspective view of the embodiment illustrated in FIG. 6.

FIG. 8 is a partially exploded front view of the embodiment illustratedin FIG. 6.

FIG. 9A is a perspective view of one embodiment of the dispenser cap ofthe present invention.

FIG. 9B is a front view of the dispenser cap illustrated in FIG. 9A.

FIG. 9C is a section view taken along lines 9C-9C of FIG. 9B.

FIG. 10A illustrates one embodiment of an adjunctive chamber suitablefor use with the present device.

FIG. 10B is a front view of the adjunctive chamber illustrated in FIG.10A.

FIG. 10C is a side view of the adjunctive chamber illustrated in FIG.10A.

FIG. 10D is a rear view of the adjunctive chamber illustrated in FIG.10A.

FIG. 10E is a top view of the adjunctive chamber illustrated in FIG.10A.

FIG. 10F is a section view of the adjunctive chamber taken along lines10E-10F of FIG. 10E.

FIG. 11A is a perspective view of one embodiment of the sleeve of thepresent invention.

FIG. 11B top view of the sleeve illustrated in FIG. 11A.

FIG. 11C bottom view of the sleeve illustrated in FIG. 11A with portionsillustrated in phantom.

FIG. 11D front view of the sleeve illustrated in FIG. 11A.

FIG. 12A is perspective view of one embodiment of the lever of thepresent invention.

FIG. 12B is a top view of the lever illustrated in FIG. 12A.

FIG. 12C is a left side view of the lever illustrated in FIG. 12A.

FIG. 12D is a right side view of the lever illustrated in FIG. 12A.

FIG. 12E is a top view of the lever illustrated in FIG. 12A.

DETAILED DESCRIPTION

It is to be understood that while a certain form of the invention isillustrated, it is not to be limited to the specific form or arrangementherein described and shown. It will be apparent to those skilled in theart that various changes may be made without departing from the scope ofthe invention and the invention is not to be considered limited to whatis shown and described in the specification and any drawings/figuresincluded herein.

Referring to FIGS. 1-12, embodiments of the present invention relate toa method and apparatus of applying an anesthetic. In some embodiments,the apparatus comprises an elongated tubular housing 1 having an outerwall 2, an upper end 3, a substantially hollow interior, and a lower end4 having an injection needle 5 extending therefrom. On the housing outerwall is an elongated opening 6 in communication with an anestheticchamber 7 formed within the housing interior. The anesthetic chamberreceives a cartridge 8 having a conventional dental anesthetic storedtherein.

The outer wall also includes a smaller opening 9 that is incommunication with an adjunctive chamber 10 for receiving a canister 11.The canister includes an endothermic gas (vapor) or “freeze spray”solution that rapidly absorbs heat when dispersed into the atmosphere.

Coaxially received within the anesthetic chamber is a plunger 12 havinga thumb ring 13 at an upper end and a spear 14 at a lower end; the spearpenetrates a membrane on the upper end of the anesthetic cartridge toforce fluid therein into the injection needle.

Coaxially received within the adjunctive chamber is a depressibletrigger 15 having a handle 16 at an upper end that protrudes from theupper end of the housing. Depressing the trigger opens the valveassembly 17 of the canister 11 propelling the gaseous or vaporoussolution contained within canister 11 through an outlet nozzle 20 on thelower end of the housing. The nozzle 20 is oriented to project a streamof gas or vapor along a delivery axis 31 that intersects a delivery axis30 of the needle, preferably at a point 40 immediately adjacent to theneedle outlet. Accordingly, a practitioner can first deaden a proposedinjection site and then immediately insert the needle with littlemovement or repositioning of the syringe.

The method of applying an anesthetic using the syringe described aboveincludes initially dispersing the heat-absorbing, endothermic gas orvapor from the canister 11 onto a proposed injection site by depressingthe trigger 15. Because of its physical properties, the heat-absorbingsubstance constricts blood flow at the injection site, and temporarynumbing occurs. The freeze spray stops the propagation of the painfulnerve stimuli and the patient feels the tactile or pressure as opposedto the pain sensation. The pressure nerve fibers supersede the painfulnerve fibers so that the mechanical contraction of the muscles blocksthe transmission of pain perception, according to the Gate theory. Theuse of the endothermic “freeze spray” also temporarily distracts thepatient by creating a “popping” noise (due to the boiling of the liquidunder pressure) that diverts the patient's attention away from anypotential or anticipated pain. Finally, because the solution blanchesthe mucosa, a readily-visible target is created for insertion of theneedle to assure that the deadened area is not bypassed. The aerosolpropellants or gas (vapor) used as anesthetic herein, avoid thedrawbacks associated with traditional anesthetics. The gas or vaporfreezes (blanches) the area of administration allowing for the painlessinsertion of the needle to deliver the pharmaceutical drug, vaccine,BOTOX®, hair transplant and the like.

When the practitioner observes that the injection site mucosa has beenblanched, the site is effectively deadened and a painless, concomitantinjection is possible. The practitioner can then quickly inject theanesthetic into the blanched injection site by inserting the injectionneedle 5 and depressing the plunger 12. Because of the positioning ofthe gas or vapor outlet nozzle 20 and needle outlet 21, the dispersal ofthe gas or vapor and subsequent injection of anesthetic can beaccomplished almost concurrently and with no pain to the patient.

Referring to FIGS. 3, 4A-C, 9A-C, 10A-F, 11A-D and 12A-E alternativeembodiments of the present invention are illustrated. In theseembodiments an apparatus comprising a module 44 which is removablyattached to a syringe barrel 62 and which accommodates a canister 11comprising a gaseous (vapor) anesthetizing composition. The module 44includes an elongated outlet nozzle 20 for directing the gaseous (vapor)anesthetizing composition to intersect with the delivery axis 30 of theneedle 5. The module includes an adjunct chamber frame 56, attachmentmeans in the form of clips 23 or a sleeve 48, a trigger 15 and an outletnozzle 20. The adjunct chamber frame 56 functions to contain thecanister 11 as well as providing support for the trigger 15, clip(s) 23and the dispenser cap 54. The trigger member 15 (FIG. 12A-E) functionsto dispense the contents of the canister 11 containing the anestheticcomposition by forcing the canister to slide within the adjunctivechamber 10 of the adjunct chamber frame 56. During the sliding action,the dispensing tube 58 of the canister 11 is pressed against thedispenser tube shoulder 55 to cause the canister valve 17 to openallowing compressed gas to escape through the dispenser tube 58. Thetrigger 15 is secured to the adjunct chamber frame 56 via pivot pins 60.The pivot pins 60 cooperate with pivot apertures 59 in the adjunctchamber frame 56. The pivot pins are positioned to allow the trigger torotate thereabout so that the handle 16 can be utilized to force the ram66 against the base of the canister 11 to cause the movement within theadjunctive chamber 10 to allow the pressurized gas to be released. Abiasing means in the form of a spring 68 may be utilized to return thetrigger to its original position. In some embodiments, the module 44 isdisposable. In other embodiments, the syringe 42 is disposable. In yetother embodiments, the canister 11 is disposable. In other embodiments,any one or combination of parts of the apparatus is disposable.

Still referring to FIGS. 3, 4A-C, 9A-C, 10A-F, 11A-D and 12A-E, themodule 44 includes an adjunctive chamber 10 for accepting a gascartridge 8. The outer diameter of the module includes an attachmentmeans which may comprise a clip 23 (FIG. 3) or sleeve 48 (FIG. 4A) whichare adapted to cooperate with the outer diameter of a syringe barrel 62for securing the module to the syringe. The clip 23 preferably includesa pair of arcuate members 24 made of a flexible resilient material sothat the arcuate members may be temporarily enlarged by flexing to allowthe arcuate members to snap over the outer diameter of the syringebarrel 62. In this manner, the module may be attached to syringe barrelsof differing diameters to provide versatility to the device. The sleevemember 48 is also constructed from a flexible resilient material, suchas plastic, and includes a slot 49 extending between two barrels 45, 47.In operation, the slot 49 may be expanded to allow the first and secondbarrels 45, 47 to be slipped over the outer diameter of the module 44and the syringe 42. A fastener 51 may be provided to compress the slot49 in the sleeve member 48 to prevent slippage of the assembly duringuse.

Referring to FIGS. 9A-C, the dispenser cap is illustrated. The dispensercap is used to close the end of the adjunct chamber frame 56 and tocooperate with the valve assembly 17 to cause the pressurized gas to bedispensed. In the preferred embodiment, the first end of the dispensercap includes threads 70 which secure the dispenser cap to the adjunctchamber frame 56. Alternatively, adhesive, bayonet mount, friction fitsor the like may be utilized to secure the dispenser cap to the adjunctchamber frame without departing from the scope of the invention. This isbest seen in FIGS. 9 and 10 wherein the threaded cap 224 comprises anopening 27 and an engagement means, e.g. a valve 226 to engage thecanister and for delivery of metered diseases of aerosol propellants. Arestrictor jet 74 may be utilized to control the flow of gas through theoutlet tube. The second end of the dispenser cap includes an outletnozzle bore 72 sized to cooperate with the outlet nozzle 20 forpositioning thereof. In the preferred embodiment, the outlet nozzle 20is adhered or frictionally fit to the dispenser cap. The outlet nozzle20 can be rigid, flexible or semi-flexible. The outlet nozzle 20 idtubular in construction having a distal end 51 with an opening 52 thatmay, if desired, be defined by an insert e.g. nozzle, venturi or thelike, inserted into the opening 52 and having a particularly configuredpassageway, to cause the anesthetic sprayed therefrom to spray in adesired pattern. The distal end of the nozzle 20 can be flexible and maybe bent by a physician into a desired angulation so that the anestheticis sprayed in a desired location with respect to the location where thesyringe needle will be inserted beneath the skin of the patient. Theneedle 5 can be varied in length, for example, shortened or elongated,so it extends beyond the distal termination of the outlet nozzle 20 sothat the nozzle 20 doesn't interfere with insertion of the needlesubcutaneously.

As shown in FIG. 3, a disposable syringe 42 is illustrated inconjunction with the module of the present invention. The disposablesyringe includes an elongated barrel 62 that is typically cylindrical inouter configuration, a plunger 12 having a thumb pad 43 or ring 13(FIG. 1) that is engaged by the thumb or finger of the user, and aperpendicular tab 61 on the barrel 62 of the syringe 42 that is graspedby other fingers of the user while the ring or pad 13 is being pushed tocause the plunger 12 to move in a direction toward the distal end 50 ofthe barrel 62. The plunger 12 pushes the medicament or liquid in thechamber 7 through the needle. The needle 5 is attached to the distal endof the syringe via, locking taper, luer lock 46 or the like to allowfluid to flow into and through the needle 5. As is well known, theneedle is thin and hollow permitting the medicament within the chamber 7to be dispensed therethrough. The needle 5 can be of any length so longas its distal end extends beyond the end of outlet nozzle 20.

In the various embodiments, the anesthetic comprises one or more gas orvapor or aerosol propellants. These propellants can be any type ofaerosol propellants as long as they continue to decrease the temperatureof the patient's skin or mucosal area targeted for an injection.Examples are the aerosol propellants sold by DuPont Company, Wilmington,Del., under the trade names DYMEL™ 134a and DYMEL™ 227a. In preferredembodiments, the anesthetic comprises a blend of two aerosol propellantsin varying percentages of weight/weight (w/w). The range of DYMEL™ 134acan be from about 0.001% to 99.999% w/w and the weight of DYMEL™ 227acan be from about 0.001% to 99.999% w/w. In other embodiments, one ormore compounds, pharmaceutical grade compounds or compositions can beincluded; for example, compounds which alter the vapor pressure of thegas or vapor being emitted. Pharmaceutical compounds include, forexample, antimicrobial, taste altering compounds or flavoring compounds,e.g. menthol, mint, etc., therapeutically effective compounds and thelike. In preferred embodiments, the aerosol propellants (e.g. DYMEL™134a, DYMEL™ 227a) are pharmaceutical grade and shown to be safe forinhalation, ingestion, and for use in sensitive areas of a patient, e.g.eyes, lips, nose etc. These pharmaceutical grade aerosol propellants canbe obtained from DuPont Company, Wilmington, Del.

The anesthetic is preferably contained within a small or specializedcanister of the type typically utilized for metered dose inhalers (e.g.,asthma) and includes a deep drawn metal canister constructed from ametal such as aluminum or steel. The deep drawn canister (FIG. 4D)includes a valve assembly 17 crimped and sealed within the open end ofthe metal canister to create a sealed pressure canister that is lightweight and portable. The aerosol propellants are contained within themetal canister under pressure so that depression of the dispenser tube58 releases the propellant through the valve assembly. In operation, thedispenser tube 58 of the valve assembly 17 may be operated in a varietyof manners which may include, but should not be limited to, fingernozzles, levers, cams, solenoids or the like which permit the valve tobe depressed for release of the propellant.

The location on the surface area of the patient where an injection is totake place is determined and the syringe 42 with the module 44 attachedthereto is positioned at a desired location and angle of skinpenetration approximately 1 to 2 centimeters above the skin. The lever15 is depressed to engage the valve to permit flow of the anesthetic,e.g. an aerosol propellant (vapo-coolant), for a period of time, such as1 to 3 seconds. Either while the aerosol propellant is flowing or justafter the flow of the aerosol propellant is stopped, the skin is thenpenetrated by the needle of the syringe 5 to a desired depth and themedicament is injected to numb in a separate location, one at a time.Injections may be first, subcutaneous, then intramuscular orintradermal. The anesthetic can be administered at various depths insequence of the dermal layers to make sure that the area is numb, suchthat a patient will not feel any pain when the needle, e.g. i.v.injection is inserted. In some embodiments, the first dermal or skinlayer is numbed first, and then the next layer etc., in sequence. Ifdesired, the needle may be retracted a desired distance with additionalinjection occurring or may be removed so that the next location can bechosen. During the step-wise process of injection including multipleinjections at the same site of needle penetration, additional aerosolpropellants may be dispensed as desired to maintain the numbness of theskin at that location. If during the process of injection, the canister11 runs out of anesthetic, e.g. an aerosol propellant, it may be removedfrom the adjunct chamber frame 56 and replaced with a replacementcanister. In embodiments where a large area is targeted for numbing, alarger volume or quantity of aerosol propellant in a large canister 90can be carried so as not to contaminate the field or location and toprevent cross contamination (FIGS. 5A, 5B). In some embodiments, theapparatus comprises an assembly which is attachable to a user's clothesor belts, or a back-pack carrying any further number of doses ofpropellant. In this manner, the user is not required to replace a spentcanister. The assembly is connected to the remote valve assembly 80 viaa long flexible tube 91 which can be extended or retracted as needed bythe user, and is actuated in a similar manner as with the smallercanister 11 or the tube is connected to the canister thereby providing areservoir of aerosol propellant. The canister may also be refillable andmay additionally include regulators or the like known in the art forreducing pressure from large high pressure tanks. When the injectionprocess is completed, the syringe 42 may be removed from the clipportion 23 and suitably discarded and the module 44 may be re-used withother syringes or for single use per point to preventcross-contamination. It should also be noted that while the preferredembodiment entails placing the large canister in a fixed position, thecanister may optionally include an attachment means for securing thecanister to the belt or back of the user to provide mobility to the userwhile still providing the added capacity of the larger canister.

As such, in this way, the present invention provides an effective way ofdispensing an anesthetic onto the skin of a patient where an injectionis to take place so that the injection is painless. The presentinvention is not limited for use in association with injections in theface for aesthetic enhancement. Rather, it may be used as an attachmentto any syringe or other injection device used to inject any medicationfor any purpose. For example, the inventive device may be used withinjection devices associated with diabetes glucose monitors, BOTOX®,hair transplants, multiple needle allergy introducers and the like.

Referring to FIGS. 1 and 2, the apparatus comprises an elongated tubularhousing 1 having an outer wall 2, an upper end 3, a substantially hollowinterior, and a lower end 4 having an injection needle 5 extendingtherefrom (FIGS. 1, 2). On the housing outer wall is an elongatedopening 6 (in communication with an anesthetic chamber 7 formed withinthe housing interior. The anesthetic chamber receives a cartridge 8having a conventional dental anesthetic stored therein.

The outer wall can also include a smaller opening 9 (FIG. 1). Thereceptacle or adjunctive chamber 10 for receiving a canister 11 (FIG.2). The canister includes an endothermic gas or vapor or “freeze spray”solution that rapidly absorbs heat when dispersed into the atmosphere.Coaxially received within the anesthetic chamber is a plunger 12 havinga thumb ring 13 or other means for pushing the plunger at an upper end.

Coaxially received within the adjunctive chamber is a depressibletrigger 15 having a handle 16 at an upper end that protrudes from theupper end of the housing. Depressing the trigger propels the gaseous orvapor propellant through an outlet nozzle 20 on the lower end of thehousing. The nozzle 20 is oriented to project a stream of gas or vaporalong a delivery axis that intersects a delivery axis of the needle,preferably at a point immediately adjacent to the needle outlet.Accordingly, a practitioner can first deaden a proposed injection siteand then immediately insert the needle with little movement orrepositioning of the syringe.

Referring to FIGS. 6-8, an alternative embodiment of the present deviceis illustrated. This embodiment utilizes a reusable syringe incombination with the Module 44 and the sleeve 48 for attaching themodule to the syringe. This embodiment also illustrates that the moduleand the sleeve may be constructed from metal without departing from thescope of the invention.

In some embodiments, the module 44 may be constructed and arranged toaccommodate two or more canisters 11. The arrangement of the two or morecanisters or modules can be arranged in any manner and can be of varyingdimensions and shapes. For example, the modules can be attachedtogether. In some embodiments, the modules 44 are arranged to be oneither side of the syringe. One of ordinary skill in the art canenvisage possible combinations, locations, patterns and designs for thereceptacles.

Referring to FIG. 8, the container or canister 11 which contains one ormore gases or vapors comprises a neck 111 having an end cap 112 and adispenser tube 58 dimensioned for slidable insertion and engagement ofthe dispenser cap 54 of the module 44 (FIG. 8). The canister contentscan be any type of anesthetic. In embodiments, the anesthetic comprisesone or more gases (vapors). Examples include, without limitation,aerosol propellants, endothermic gases (vapors) that rapidly absorb heatwhen released to the atmosphere and the like. Accordingly, a user caninitially disperse the gas or vapor composition onto the injection siteto minimize any pain and discomfort associated with an injection.Subsequently, the practitioner inserts the needle into the deadened site(blanched) and injects the contents of the syringe. As discussed above,the receptacle can be of any size and shape to accommodate canisters orcontainers of varying sizes and shapes. The size of the canisters useddepends on the volume of the anesthetic, e.g. gas or vapor needed forthe particular procedure. Different blends produce differenttemperatures; therefore, the doctor in charge can decide which of theblends to utilize for the necessary effect. In some embodiments, thetemperature of the gas or vapor when administered is above freezingtemperature to avoid necrosis, frost bite, pain, discomfort or any typeof biological damage to the area of administration. Since the medicalcaregiver, e.g. doctor, controls the delivery of the anesthetic, e.g.gas or vapor, the doctor is in charge of the delivery of the gas orvapor to enhance the patient comfort, therefore, the doctor can addadditional bursts if the patient informs the doctor that more is needed.

Referring to FIGS. 5C-K, an alternative embodiment of the presentinvention is illustrated. In this embodiment, the module 144 isconstructed and arranged to be secured to the syringe 42 in aperpendicular arrangement with respect to the syringe. The adjunctchamber frame 156 is still constructed to allow the insertion of aportion of the canister 11. The distal end of the adjunct chamber frame156 includes the dispenser tube shoulder 55 for accepting the dispensertube 58. In this embodiment, the trigger 115 is constructed and arrangedto cooperate with the neck 111 of the canister 11 to provide controlleddispensing of the pressurized gas. The trigger 115 is provided with apivot pin 160 which allows the ram 166 to catch under the neck to causethe canister to move within the adjunct chamber frame. Return spring 168returns the trigger to its original position. An outlet tube 120 extendsout of the adjunct chamber frame 156 at an angle that is substantiallyperpendicular with respect to the canister 11. The outlet tube 120therefore provides a body to cooperate with the sleeve 48 or clip 23 forready attachment to reusable or disposable syringes. The outlet tubealso functions to secure and position the outlet nozzle 20 which may betelescopingly engaged to the outlet tube to allow the length of theoutlet nozzle to be adjusted.

It should also be noted that while not shown, a small laser light or thelike may be secured to the module 44, 144 to indicate the trajectory ofthe pressurized gas. In this manner, the user would be provided with avisual guide to where the gas will strike the patients skin.

The above-described device is not limited to the exact details ofconstruction and enumeration of parts provided herein. For example, thereceptacle could comprise separate components, e.g. a separate clip thatis attachable to the receptacle and to any conventional syringe. Theendothermic gas or vapor should remove sufficient heat to function asdescribed without causing necrosis. The concentration and volume of thepropellant components can be varied to deliver small doses ofhighly-concentrated substances, or a prolonged, continuous dispersal ofdiluted substances. The canister can also be color coded for varyingtemperatures produced by the different blends or aerosol propellants. Inaddition, gas or vapor delivery can be automated with a laser mechanismthat dispenses gas or vapor when the needle is within a minimal distancefrom the skin and automatically disables gas or vapor flow upon needlepenetration. Accordingly, a practitioner can rapidly inject multiplesites. Finally, although the device has been primarily described anddepicted as a syringe, the gas or vaporous canister could have otheruses. For example, it could be attached to a scalpel blade to allow aquick, painless incision when performing certain procedures, such asremoving moles. Furthermore, the size, shape and materials ofconstruction of the various components can be varied.

One skilled in the art will readily appreciate that the presentinvention is well adapted to carry out the objectives and obtain theends and advantages mentioned, as well as those inherent therein. Theembodiments, methods, procedures and techniques described herein arepresently representative of the preferred embodiments, are intended tobe exemplary and are not intended as limitations on the scope. Changestherein and other uses will occur to those skilled in the art which areencompassed within the spirit of the invention and are defined by thescope of the appended claims. Although the invention has been describedin connection with specific preferred embodiments, it should beunderstood that the invention as claimed should not be unduly limited tosuch specific embodiments. Indeed, various modifications of thedescribed modes for carrying out the invention which are obvious tothose skilled in the art are intended to be within the scope of thefollowing claims.

What is claimed is:
 1. An injection apparatus comprising: a syringe,said syringe including an outer wall having a hollow interior, an upperend and a lower end, an injection needle extending from said lower end,a plunger received in said hollow interior for forcing liquid from saidhollow interior through said injection needle, an adjunctive chambersized to receive a canister, said adjunctive chamber attached to saidsyringe, said canister having a compressed endothermic gas therein, anactuating member for dispensing contents from the canister, and anoutlet nozzle for dispensing contents from said canister along adelivery axis that intersects a delivery axis of said injection needle.2. The injection apparatus of claim 1, wherein said compressedendothermic gas in the canister is dispensed when a user operates meansfor dispensing said compressed endothermic gas through said outletnozzle.
 3. The syringe assembly of claim 1, wherein said canistercontaining a compressed endothermic gas includes a valve, an actuatingmember is connected to the valve for dispensing the contents of thecanister through the nozzle, the contents of canister being sprayed fromthe nozzle topically onto a skin surface.
 4. The syringe assembly ofclaim 1, wherein a nozzle trajectory is along a delivery axis thatintersects a delivery axis of said needle positioned on said syringe. 5.A syringe comprising: an elongated tubular housing having an outer wall,a substantially hollow interior, an upper end and a lower end; aninjection needle extending from the lower end of the housing; anadjunctive chamber or receptacle secured to said tubular housing; acanister received within said adjunctive chamber or receptacle, saidcanister having a compressed, endothermic gas or vapor therein thatrapidly absorbs heat when released to the atmosphere; means fordispensing a pharmaceutical composition through said injection needle;an outlet nozzle in fluid communication with said canister; means fordispensing said gas or vapor through an outlet nozzle.
 6. The syringeaccording to claim 5, wherein said means for dispensing saidpharmaceutical composition through said needle comprises: saidpharmaceutical composition in said hollow interior being in fluidcommunication with said needle; a plunger received within said hollowinterior that, when depressed, forces the pharmaceutical compositionfrom said hollow interior into said needle.
 7. The syringe according toclaim 5, wherein said nozzle is oriented to project said gas or vaporalong a delivery axis that intersects a delivery axis of the needleallowing said gas or vapor and said pharmaceutical composition to besuccessively delivered to an injection site with minimal repositioningof the housing.